By Thomas N. Warren
The National Fire Protection Association (NFPA) released its annual Firefighter Injuries in the United States report in October 2013. The report identifies where, how, the types of injuries, that firefighters suffered in the calendar year 2012. It also provides a detailed analysis of the deaths and injuries suffered by firefighters as well as some recommendations to improve firefighter safety.
The final analysis indicates that there were a total of 69,400 firefighter injuries in the line of duty in 2012. This number represents a decrease of one percent from 2011, when 70,090 injuries were reported. This is a slight improvement, but it does not indicate a long-term statistical downward trend. It is important to note that the injuries reported in 2012 were markedly improved from the 1980s and 1990s. We should celebrate the fact that we are on the correct path, although we seem to be traveling very slowly toward our goal.
As most fire departments across the country move into advanced life support services, there is a corresponding increase in the numbers of injuries associated with the delivery of emergency medical services (EMS). Firefighters are now being exposed to diseases such as hepatitis, meningitis, HIV, and flu viruses with greater frequencies than they were in the 1980s and 1990s. The EMS provided by most fire departments in 2012 added a new dimension to what was once thought of as firefighter injuries. In 2012, there were 8,150 EMS exposure injuries.
Following along the same lines as EMS delivery injuries is the addition of hazmat service delivery. The fire service has added hazmat services to its workload in recent years. Modern fire departments are now “all hazards” emergency service organizations creating additional risk for firefighters now being exposed to materials and gases such as asbestos, radioactive materials, chemicals, and various fumes. These materials are not outwardly harmful when handled in their controlled environment, but when firefighters come in contact with them, something has usually gone wrong with their handling or use, and firefighters are introduced into an uncontrolled situation. This is a relatively new exposure for potential firefighter injuries. Hazmat injuries reported in 2012 totaled 19,200 exposure injuries.
By far, the most common injuries occurred on the fireground. The NFPA defines fireground injuries as those injuries that occur from the time that firefighters arrive on the scene until they board their apparatus to leave the scene. Firefighters across the United States suffered a total of 31,490 injuries while operating on the fireground. Fireground injuries typically include injuries such as strains, sprains, muscular pain, wounds, falls, cuts, bleeding, bruises, thermal injuries, and burns. These injuries are the part of the history of the fire service dating back to Benjamin Franklin’s Union Fire Company in Philadelphia, Pennsylvania, and were very common in the 1970s and 1980s. But, they have been trending downward and have now remained somewhat neutral during the last several years. Fireground injuries over the past five years were, respectively, 30,505 in 2011; 32,675 in 2010; 32,205 in 2009; 36,995 in 2008; and 36,595 in 2007. The breakdown of these injuries reveals that, despite the many improvements in a firefighter’s equipment, these physical injuries were still occurring. The sprain/strain type injures accounted for 55.2 percent of the fireground injuries, laceration/bruises injuries accounted for 12.2 percent of the fireground injuries, and thermal stress and burns accounted for 5.7 percent of the fireground injuries. It is also interesting to note that 58.5 percent of the non-fireground injuries were in the form of muscular pain, strains and sprains.
The NFPA states in the 2012 report that “firefighters work in varied and complex environments that increase the risk of on-the-job death and injury.” As professional firefighters, we all know that our work environment has not improved dramatically. In fact, it has worsened in recent years for a variety of reasons such as products of combustion, building construction features, staffing, and improper funding, to name a few. It is fair to say that firefighter work environments are not likely to improve in the near term, which forecasts a continuation of these fireground injury numbers.
The fire service has made many improvements in the way fireground operations take place. Many of the improvements made in recent years are based on the annual death and injury reports produced by the NFPA and other NFPA safety standards. I feel that, overall, firefighters are in a much better place than they were just 20 years ago.
The improvements in technology, equipment, policies and procedures, health and safety, professional development, and apparatus have led the fire service to a safer workplace. The fire service has improved through the efforts of several fire-related organizations such the International Association of Fire Chiefs, the International Association of Fire Fighters, and the NFPA. These organizations have brought forth operational changes such as NFPA 1500, Standard on Fire Department Occupational Safety and Health Program; annual departmental physicals; safer apparatus; seat belt programs; air management systems/equipment; annual apparatus testing/certification; operational standard operating procedures (SOPs); rapid intervention teams; exhaust removal systems; incident management systems; and the list goes on. These are measurable shifts in the way the fire service approaches, prepares, and operates on the fireground.
This shift in our approach and the execution to fire suppression did not happen quickly, nor was it accomplished without great study. Perhaps the most difficult aspect for these improvements was funding. Many of these improvements were costly to the local fire department or jurisdiction that funded the local fire department. It must be said that the “cost factor” should never be raised as a reason not to implement needed health and safety improvements but, unfortunately, convincing those who make the financial decisions for the fire service are often disconnected from the fire service and do not completely comprehend what it is that we are trying to accomplish. These big changes can only be accomplished at the national, state, and local level where deliberate and non-biased study validates these changes and improvements. Implementation rests with local fire department managers and chief officers.
So, what can the average firefighter, operating daily in his fire company, do to operate safely and improve the NFPA death and injury numbers for 2014? Well, as it turns out, there are many things that an individual firefighter can do improve the NFPA death and injury numbers and stay healthy at the same time.
One of the most important tools that firefighters use on the fireground is their self-contained breathing apparatus (SCBA). Most departments are moving from a 30-minute air bottle to a 45-minute air bottle to allow firefighters to start using air before they enter the hazard zone and to stay on air until they exit the hazard zone. Firefighters should operate according to this principle to keep all the products of combustion—known and unknown—out of their lungs. Along with using the SCBA before entering the hazard zone through to exiting the hazard zone, make sure that the waist strap is secured and the SCBA sits properly on your hips.
All too often, firefighters leave the waist straps hanging down as they operate on the fireground. Leaving the waist straps hanging (along with the face mask) is inviting an entrapment on some unknown fireground object. The entrapment potential is serious and real, but wearing the SCBA without securing the waist strap will cause muscle fatigue and possible injury. If your department does not have an air management policy, you can easily develop one through your department’s health and safety committee. There are many quality programs already in existence that you can use as a guide.
Firefighters regularly operate in a rushed fashion, responding as quickly as possible to render the emergency service that is needed. When we rush, we usually try to cut corners; this is true in our personal lives as well as our professional lives. Take the time to use all the personal protection equipment (PPE) you have at your disposal.
As someone who served as a company officer, incident commander, and fire service educator, I have witnessed many cases where firefighters do not use all the PPE afforded to them. I don’t feel it is out of ignorance but more a case of trying to get into the action as soon as possible. I have witnessed firefighters not using their hoods or helmet ear flaps; in unsecured fire coats or leather boots; wearing no fire coat, pants, gloves, or helmet; not using eye protection; not using reflective vests while operating in traffic; forgetting their portable radios; not activating the pass device; and, probably the worst of all, not using SCBA. All of this safety equipment has seen extensive improvement in recent years for the sole purpose of protecting individual firefighters. Don’t let all these years of innovation go to waste, sacrificing your health in the process.
Ventilation is one of the basic operational goals during building fires. There are many variables involved in selecting the best ventilation tactic at each building fire. One of the most common tactics used is the breaking of windows. Although this may be one of the easiest ways to ventilate a building, the breaking of glass has some unintended consequences. Falling glass from the upper stories of a building can injure firefighters working around the fire building, whether they are operating a pump, aerial ladder, moving hose, or setting up positive pressure ventilation equipment. The glass shards created by breaking plate glass can cause serious lacerations or worse. Falling glass can also cut open hoselines that are supplying the pump or the handlines operating inside a building. The damage to the hoselines is secondary to glass falling on firefighters, but the possible injuries caused by the falling glass and interrupting the water supply to an operating engine company can be devastating.
Another dangerous situation develops when firefighters break out a window but do not clear the glass from the window frame and sashes. Punching out a window and leaving jagged pieces of glass can cause serious lacerations. If breaking a window is the preferred ventilation tactic, firefighters must finish the job by clearing all the glass from the window.
Firefighting operations are organized around the concept of fire companies completing assigned tasks. Many times, when firefighters suffer muscular injuries, sprains, and strains, it is a result of firefighters trying to do more than one person is capable of doing. Company officers should maintain company integrity and operate as a team to accomplish assigned tasks. If a long-diameter hose needs to be moved, a ground ladder thrown, a burned mattress needs to be removed from a building, or heavy equipment must be set up, make sure there are sufficient personnel to accomplish the job. Company officers need to keep their company informed of possible trip and fall hazards and, most importantly, to make sure their company is rotated through rehab early. Many injuries occur in the later stages of a building fire when the firefighters are fatigued.
Power tools are inherently dangerous tools to operate on the fireground. When power tools are used, particularly power saws, it is usually in a smoky environment to achieve effective ventilation. Working with power saws requires a high level of skill and situational awareness for the operator and those around him. Fire officers should never allow saws to be used above the operator’s head or from a ground ladder. The potential for the operator to lose control and cause serious injury is too great and not worth the risk involved. I recently viewed a video of a firefighter operating a chain saw above his head from a ground ladder at a low angle with another firefighter below him on the ladder, simply watching the operation. If the chain saw kicked back, there is no telling how seriously injured either of these two firefighters would have been.
Last, we need to take a look at proper line selection. Too many times firefighters instinctively pull the 1¾-inch preconnect for all building fires or use a booster line for auto fires. These common mistakes can leave the engine company at risk for burn injuries when the required flow for the fire is not met with the line selected. For an engine company finding heavy fire on arrival, the situation will require the flow that only a 2½-inch hand line can deliver. Auto fires are a dangerous mix of toxic gases, flammable liquids, plastics, and blinding smoke. The best and safest way to approach an auto fire is with a 1¾-inch line with SCBA in use. The 1¾-inch line will provide the required flow necessary to extinguish the fire while providing the protection the firefighters need, and the SCBA will provide the needed respiratory protection that is required at these toxic fires. These two simple approaches to heavy fire on arrival and auto fires will minimize the potential for burn and respiratory injuries at these kinds fires and set the trend for long-term health.
These are some simple ways to accomplish safer approaches to our normal everyday firefighting operations. These suggestions are related directly to the fieground activities, which account for the bulk of firefighting injuries. Other areas of our firefighting activities can and should be examined for safer operations as well.
Responding/returning injuries, firehouse injuries, training injuries, and other emergency operations such as auto accidents and EMS and physical training injuries also deserve close attention by firefighters and fire officers.
As firefighters we often work in uncontrolled environments with dangers at every turn, but we also have the ability to control some of the known dangers that can cause us injuries. If we can control our working environment, even to a small extent, we should make every effort to do so; it’s for our families and ourselves that we should.
Thomas N. Warren has more than 40 years of experience in the fire service in both career and volunteer departments. He retired as assistant chief of department of the Providence (RI) Fire Department after 33 years of service. Presently he is a faculty member at Bristol Community College in the Fire Science Technology Program teaching a variety of subjects in the fire science discipline. He holds a Bachelor’s Degree in fire science from Providence College, an Associate Degree in business administration from the Community College of Rhode Island and a Certificate in Occupational Safety and Health from Roger Williams University.